부산대학교 도서관

Simple Summary: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer in North America, with a survival rate of 85%. Despite improved outcomes, many survivors experience long-term side effects, including cognitive issues. This study investigates whether a brain imaging technique called Magnetization Transfer Ratio (MTR) can detect changes in the brain's white matter of ALL survivors and if these changes are related to cognitive problems. Lower MTR levels in survivors, indicating myelin damage, correlated with cognitive impairments. Additionally, a link between MTR levels and the doses of certain chemotherapy drugs received was discovered. These findings improve our understanding of ALL survivorship and highlight the importance of MTR in monitoring brain health during and after cancer treatment. Acute lymphoblastic leukemia (ALL) stands as the most prevalent form of pediatric cancer in North America, with a current five-year survival rate of 85%. While more children achieved ALL remission and transition into adulthood, the prevalence of long-term treatment-related effects, especially neurocognitive sequelae, remains significant. This study pursues two objectives. Firstly, it investigates if Magnetization Transfer Ratio (MTR), a method assessing myelin integrity, is sensitive to white matter (WM) microstructural changes in long-term ALL survivors and whether these relate to cognitive impairments. Secondly, it examines the dose-related effects of chemotherapy agents on the MTR and its relationship to other risk factors such as female sex, early age diagnosis, and cranial radiotherapy. Magnetization transfer imaging was utilized to assess WM integrity in 35 survivors at a mean of 18.9 years after the onset of ALL (range since diagnosis: 6.9–26.8). Additionally, 21 controls matched for age, sex, and education level, with no history of cancer, were included. MTR was extracted from both the entire brain's WM and the corpus callosum through semi-automated procedures. The results indicated lower MTR means in survivors, which is linked to cognitive function. Negative associations between MTR means and intrathecal agents' (MTX, cytarabine, and hydrocortisone) cumulative doses received were highlighted. This study offers valuable insights into the connections between myelin deterioration, cognitive impairment, and the implications of IT chemotherapy, enhancing our understanding of ALL survivorship dynamics. It underscores MTR's relevance in monitoring neurotoxicity during oncological drug follow-up examinations. [ABSTRACT FROM AUTHOR]